1
|
Draelos Z, Bogdanowicz P, Saurat JH. Top weapons in skin aging and actives to target the consequences of skin cell senescence. J Eur Acad Dermatol Venereol 2024; 38 Suppl 4:15-22. [PMID: 38881445 DOI: 10.1111/jdv.19648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 11/13/2023] [Indexed: 06/18/2024]
Abstract
Skin aging has long been considered a purely cosmetic problem. However, as life expectancy increases, skin aging is taking on a functional dimension that goes beyond cosmetics and appearance. Preventive or therapeutic strategies are needed to target cellular senescence, a key process underlying the alterations in skin function and appearance that occur with aging, as well as to address the age-related skin changes associated with 'dermatoporosis' and chronic skin insufficiency/fragility syndrome. Thus, given the need for effective anti-aging products that improve both the appearance and function of the skin, it is essential to distinguish active ingredients that have been proven to be effective, among the large number of available over-the-counter cosmeceuticals. This brief review focuses on a core group of topical actives, describing their clinical effects on senescence and aging, and their molecular mechanisms of action. These actives include hyaluronic acid, which has hydrating and viscoelastic properties and has been shown to reduce skin atrophy; retinaldehyde, which activates retinoid receptors and increases cutaneous elasticity; vitamins C and E, which provide stable oxidative protection; and niacinamide, which reduces inflammation and mitigates the effects of senescence.
Collapse
Affiliation(s)
- Z Draelos
- Dermatology Consulting Services, PLLC, Department of dermatology Duke University School of Medicine, High Point, North Carolina, USA
| | - P Bogdanowicz
- Department of Pharmacology and Clinical Research, Pierre Fabre Dermo-Cosmétique, Toulouse, France
| | - J-H Saurat
- University of Geneva, Geneva, Switzerland
| |
Collapse
|
2
|
Cristina L, Nyffeler RW. Extensive skin laceration on the forearm due to closed reduction of a dislocated shoulder. A case report. Trauma Case Rep 2024; 51:101001. [PMID: 38835528 PMCID: PMC11148510 DOI: 10.1016/j.tcr.2024.101001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2024] [Indexed: 06/06/2024] Open
Abstract
We report the case of an 80-year-old man who suffered an anteroinferior shoulder dislocation with rupture of the rotator cuff following a fall. An attempt at closed reduction under analgosedation resulted in extensive skin laceration on the elbow and forearm. The wound treatment was complex and resulted in numerous complications.
Collapse
Affiliation(s)
- Luca Cristina
- Orthopädie Sonnenhof KLG, Bern, Switzerland
- Campus Stiftung Lindenhof Bern (Campus SLB), Bern, Switzerland
| | - Richard W Nyffeler
- Orthopädie Sonnenhof KLG, Bern, Switzerland
- Campus Stiftung Lindenhof Bern (Campus SLB), Bern, Switzerland
| |
Collapse
|
3
|
Truchetet A, Goetz C, Bursztejn AC. Prevalence and comorbidities of dermatoporosis: A French prospective observational study in general medicine consultation. J Eur Acad Dermatol Venereol 2023; 37:e1465-e1467. [PMID: 37471483 DOI: 10.1111/jdv.19366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 07/18/2023] [Indexed: 07/22/2023]
Affiliation(s)
- A Truchetet
- Department of General Medicine, Faculty of Medicine of Nancy and University of Lorraine, Nancy, France
| | - C Goetz
- Clinical Research Support Unit, Metz-Thionville Regional Hospital Center, Metz, France
| | - A C Bursztejn
- Department of Dermatology, Allergology and Venereology, Nancy University Central Hospital and University of Lorraine, Nancy, France
| |
Collapse
|
4
|
Romano F, Serpico D, Cantelli M, Di Sarno A, Dalia C, Arianna R, Lavorgna M, Colao A, Di Somma C. Osteoporosis and dermatoporosis: a review on the role of vitamin D. Front Endocrinol (Lausanne) 2023; 14:1231580. [PMID: 37693364 PMCID: PMC10484397 DOI: 10.3389/fendo.2023.1231580] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/10/2023] [Indexed: 09/12/2023] Open
Abstract
Osteoporosis (OP) and Dermatoporosis (DP) are expressions of the aging process at the skin and bone levels, respectively. Both conditions are associated with increased morbidity for elderly people, and this requires necessary interventions. They share many common risk factors; among these, vitamin D (VD) deficiency appears to have a role. VD is involved in either disease with many mechanisms, among which immunomodulation. VD deficiency has been linked to OP because it inhibits the body's capacity to absorb calcium and maintain optimal bone health. Available evidence suggests that proper vitaminosis D also appears to be vital in preventing skin age-related issues. DP is often seen in elderly individuals, particularly those with long-term sun exposure and a history of chronic sun damage. VD deficiency can be linked to DP, since its involvement in collagen production, epidermal barrier function, inflammation regulation, wound healing, and sun protection. Aim of this review is to summarize the most updated existing evidence on the role of VD in the development of fragility syndromes such as DP and OP and the possible benefits of VD supplementation as a simple and harmful weapon against aging.
Collapse
Affiliation(s)
- Fiammetta Romano
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Domenico Serpico
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Mariateresa Cantelli
- Dermatology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Antonella Di Sarno
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Carmine Dalia
- Internal Medicine S. Maria Della Pietà Hospital Nola, Nola, Italy
| | - Rossana Arianna
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Mariarosaria Lavorgna
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
| | - Annamaria Colao
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
- UNESCO Chair “Education for Health and Sustainable Development”, University of Naples “Federico II”, Naples, Italy
| | - Carolina Di Somma
- Endocrinology Diabetology and Andrology Unit, Department of Clinical Medicine and Surgery, University of Naples “Federico II”, Naples, Italy
- UNESCO Chair “Education for Health and Sustainable Development”, University of Naples “Federico II”, Naples, Italy
| |
Collapse
|
5
|
Guadanhim LRS, Miot HA, Soares JLM, Silva SAM, Leonardi GR, Lopes RD, Bagatin E. Efficacy and Safety of Topical or Oral Hydrolyzed Collagen in Women with Dermatoporosis: A Randomized, Double-Blind, Factorial Design Study. Dermatol Ther (Heidelb) 2023; 13:523-534. [PMID: 36547800 PMCID: PMC9884723 DOI: 10.1007/s13555-022-00859-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/08/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Dermatoporosis defines the progressive chronic cutaneous insufficiency syndrome. Stage I is characterized by cutaneous atrophy, senile purpura, and stellate pseudoscars. OBJECTIVE To assess clinical, histologic, quality of life, and biophysical effects of oral and/or topical hydrolyzed collagen (HC) on forearm skin of postmenopausal women with Dermatoporosis stage I. METHODS Double-blind randomized placebo-controlled factorial design study. Two groups of menopausal women with stage I dermatoporosis on forearms were randomized to oral HC 5 g/day or matching placebo, and also to topical serum 2.5% HC or matching placebo once a day, for 6 months. RESULTS A total of 56 women, age range 60-93 years (mean 69.5 ± 7.3 years) were included. Comparing data from baseline and after 6 months, no significant difference was observed for each intervention nor their comparison, for all efficacy parameters: clinical and quality of life scores, dermal elasticity, thickness and echogenicity, and histologic and immunohistochemical markers (p > 0.1). LIMITATIONS Larger studies to confirm our findings are warranted. CONCLUSIONS In menopausal women with stage I dermatoporosis, oral or topical collagen peptides used alone or in combination do not have benefits on forearm skin after 6 months of intervention, and therefore should not be used routinely in this population. CONSORT flow chart.
Collapse
Affiliation(s)
- Lilia R S Guadanhim
- Department of Dermatology, Universidade Federal de São Paulo/UNIFESP, Rua Botucatu, 821 - 5o andar, São Paulo, Brazil.
| | - Hélio A Miot
- Department of Dermatology, Universidade Estadual de São Paulo/UNESP, Botucatu, Brazil
| | - Juliana L M Soares
- Department of Dermatology, Universidade Federal de São Paulo/UNIFESP, Rua Botucatu, 821 - 5o andar, São Paulo, Brazil
| | - Silas A M Silva
- Faculty of Pharmaceutical Sciences, Universidade Estadual de Campinas/UNICAMP, Campinas, Brazil
| | - Gislaine R Leonardi
- Faculty of Pharmaceutical Sciences, Universidade Estadual de Campinas/UNICAMP, Campinas, Brazil
| | - Renato D Lopes
- Division of Cardiology, Duke University Medical Center, Durham, NC, USA
| | - Ediléia Bagatin
- Department of Dermatology, Universidade Federal de São Paulo/UNIFESP, Rua Botucatu, 821 - 5o andar, São Paulo, Brazil
| |
Collapse
|
6
|
Hamdan R, Zwetyenga N, Macheboeuf Y, Ray P. Rapidly spreading deep dissecting hematoma occurring 1 month after a minor trauma: A case report. SAGE Open Med Case Rep 2022; 10:2050313X221135257. [PMID: 36388635 PMCID: PMC9647285 DOI: 10.1177/2050313x221135257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 10/04/2022] [Indexed: 11/11/2022] Open
Abstract
A deep dissecting hematoma is the most serious complication of dermatoporosis,
consisting of a rapidly expanding blood collection that splits the hypodermis
from the muscle fascia. A several-week time lapse between a minor trauma-induced
superficial hematoma and its sudden evolution into a rapidly spreading deep
dissecting hematoma is unusual. We report the case of a 70-year-old woman with
long-term oral anticoagulation and dermatoporosis who suddenly developed a
rapidly spreading right-leg deep dissecting hematoma 1 month after minor trauma,
for which a surgical debridement and drainage were performed. Only local care
and absorbent dressings were used to manage the post-operative wound, and within
4 months, the wound had healed. In this report, we emphasize the importance of
preventing deep dissecting hematoma in patients who are at risk as well as the
need to weigh the benefits and risks of anticoagulants when dermatoporosis
cutaneous signs are present. A limb-threatening deep dissecting hematoma may
develop suddenly, even weeks after a minor impact. In order to prevent skin
necrosis from occurring, caregivers, patients, and carers must be able to
identify this condition early on.
Collapse
Affiliation(s)
- Rémy Hamdan
- Department of Angiology, Dijon Bourgogne University Hospital, Dijon, France
| | - Narcisse Zwetyenga
- Department of Plastic Reconstructive and Hand Surgery, Department of Oral and Maxillofacial Surgery, Dijon Bourgogne University Hospital, Dijon, France
| | - Yvan Macheboeuf
- Department of Plastic Reconstructive and Hand Surgery, Department of Oral and Maxillofacial Surgery, Dijon Bourgogne University Hospital, Dijon, France
| | - Patrick Ray
- Department of Emergency Medicine, Dijon Bourgogne University Hospital, Dijon, France
| |
Collapse
|
7
|
Chanca L, Fontaine J, Kerever S, Feneche Y, Forasassi C, Meaume S, Colboc H. Prevalence and risk factors of dermatoporosis in older adults in a rehabilitation hospital. J Am Geriatr Soc 2021; 70:1252-1256. [PMID: 34918778 DOI: 10.1111/jgs.17618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 11/24/2021] [Accepted: 11/25/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The term dermatoporosis (DP) is used to describe the clinical signs and functional consequences of age-related extreme skin fragility. It is associated with potentially severe complications, including deep dissecting hematomas and extended skin lacerations. No studies have evaluated the prevalence and risk factors of DP in adults aged 75 and older. METHODS The aim of our study was to assess the prevalence, complications, and risk factors of DP in a cohort of older patients hospitalized in a rehabilitation center. A case-control, single-center study was conducted between September and October 2020 in our rehabilitation ward, Rothschild Hospital, Paris, France. A senior dermatologist and a resident in geriatric medicine performed a systematic dermatological examination. The presence of DP, its stage, its location, and complications were collected, as were demographical data, comorbidities, past sun exposure, skin phototype, treatments, and biological data. RESULTS A total of 101 patients (62 women, median age 86 years [extreme values 75-104]) were included. The overall prevalence of DP was 27%. Stage 1 was the most frequent. DP was mainly located on the upper limbs. Ten (37%) patients had a DP complication: eight (30%) skin lacerations and two (7%) deep dissecting hematomas. Multivariate analysis revealed a significant association between DP and age (odds ratio [OR] 5.82, 95% confidence interval [CI] 1.67-24.92, p = 0.009), smoking (OR 8.67, 95% CI 2.59-34.85, p = 0.001), recreational sun exposure (OR 4.23, 95% CI 1.30-15.21, p = 0.02), and anticoagulant therapy (OR 4.53, 95% CI 1.32-17.26, p = 0.02). CONCLUSION Our study is the first to analyze the prevalence and risk factors of DP in older adults in rehabilitation. Frequency of DP makes it relevant for the geriatrician and should be described more to prevent potential severe complications. A multicentric study, with inpatients and outpatients, could evaluate the prevalence of DP in a more representative older adult population.
Collapse
Affiliation(s)
- Laura Chanca
- Rothschild Hospital, Sorbonne Université, Department of Geriatric Medicine - Wound and Healing, Paris, France
| | - Juliette Fontaine
- Rothschild Hospital, Sorbonne Université, Department of Geriatric Medicine - Wound and Healing, Paris, France
| | - Sébastien Kerever
- Department of Anesthesiology and Critical Care Medicine, Lariboisière University Hospital, DMU PARABOL, AP-HP. Nord, Paris, France.,Fédération Hospitalo-Universitaire PROMICE, INSERM UMR-S 942 MASCOT, Université de Paris, Paris, France
| | - Yohann Feneche
- Rothschild Hospital, Sorbonne Université, Department of Geriatric Medicine - Wound and Healing, Paris, France
| | - Christine Forasassi
- Rothschild Hospital, Sorbonne Université, Department of Geriatric Medicine - Wound and Healing, Paris, France
| | - Sylvie Meaume
- Rothschild Hospital, Sorbonne Université, Department of Geriatric Medicine - Wound and Healing, Paris, France
| | - Hester Colboc
- Rothschild Hospital, Sorbonne Université, Department of Geriatric Medicine - Wound and Healing, Paris, France
| |
Collapse
|
8
|
Villeneuve D, Lidove O, Chazerain P, Ziza JM, Sené T. Association between dermatoporosis and history of major osteoporotic fractures: A French prospective observational study in a general practice population. Joint Bone Spine 2020; 87:511-512. [PMID: 32360829 DOI: 10.1016/j.jbspin.2020.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 04/08/2020] [Indexed: 11/16/2022]
Affiliation(s)
- Delphine Villeneuve
- Department of internal medicine, Fondation A. de Rothschild, 25-29, rue Manin, 75019 Paris, France.
| | - Olivier Lidove
- Department of internal medicine, Fondation A. de Rothschild, 25-29, rue Manin, 75019 Paris, France; Department of rheumatology and internal medicine - groupe hospitalier Diaconesses - Croix St-Simon, 125, rue d'Avron, 75020 Paris, France
| | - Pascal Chazerain
- Department of rheumatology and internal medicine - groupe hospitalier Diaconesses - Croix St-Simon, 125, rue d'Avron, 75020 Paris, France
| | - Jean-Marc Ziza
- Department of internal medicine, Fondation A. de Rothschild, 25-29, rue Manin, 75019 Paris, France; Department of rheumatology and internal medicine - groupe hospitalier Diaconesses - Croix St-Simon, 125, rue d'Avron, 75020 Paris, France
| | - Thomas Sené
- Department of internal medicine, Fondation A. de Rothschild, 25-29, rue Manin, 75019 Paris, France; Department of rheumatology and internal medicine - groupe hospitalier Diaconesses - Croix St-Simon, 125, rue d'Avron, 75020 Paris, France
| |
Collapse
|
9
|
Menzinger S, Saurat JH, Kaya G. Morphological Analysis of Dermatoporosis by in vivo Reflectance Confocal Microscopy and Ultrasonography. Dermatopathology (Basel) 2020; 6:279-287. [PMID: 32309277 PMCID: PMC7154283 DOI: 10.1159/000505990] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 01/14/2020] [Indexed: 12/03/2022] Open
Abstract
Background Dermatoporosis is defined as a chronic cutaneous fragility and insufficiency syndrome. It results from chronological aging, long-term and unprotected sun exposure, genetic factors, or the chronic use of topical and systemic corticosteroids. There is currently a lack of noninvasive tools for the evaluation and quantification of dermatoporosis. Objectives The aim of this study was to define the dermal-epidermal modifications which characterize dermatoporosis using noninvasive methods such as in vivo reflectance confocal microscopy (RCM) and ultrasound (US). Subjects and Methods Seventeen patients with stage I dermatoporosis and 14 healthy volunteers were included in the study. The posterior surface of the right forearm was analyzed in all subjects, and stellate pseudoscars and senile purpura in patients with dermatoporosis were analyzed when possible. We used a commercially available reflectance confocal microscope and measured different histometric parameters (thickness of the epidermis and its different layers, cellular architecture, aspect of the dermal-epidermal junction and the dermis). We also used a commercially available US skin system to define the dermal-epidermal thickness (DET) in all subjects. Results The DET measured with the US skin system was significantly different between the two groups: mean value 1.19 mm (volunteers group) versus 0.81 mm (patient group). The significant differences measured with RCM were (1) epidermal thickness, (2) number of dermal papillae, and (3) thickness of solar elastosis. Stellate pseudoscars are also characterized by a modified dermis, with a linear organization of the collagen bundles. Conclusion US and in vivo RCM are useful tools for the diagnosis of dermatoporosis. Dermal-epidermal atrophy, reduction of dermal papillae/area, and the thickness of dermal elastosis seem to be the major histometric parameters which characterize dermatoporosis.
Collapse
Affiliation(s)
- Sébastien Menzinger
- Department of Dermatology, University Hospital of Geneva, Geneva, Switzerland
| | - Jean-Hilaire Saurat
- Department of Clinical Pharmacology and Toxicology, University of Geneva, Geneva, Switzerland
| | - Gürkan Kaya
- Department of Dermatology, University Hospital of Geneva, Geneva, Switzerland
| |
Collapse
|
10
|
Wollina U, Lotti T, Vojvotic A, Nowak A. Dermatoporosis - The Chronic Cutaneous Fragility Syndrome. Open Access Maced J Med Sci 2019; 7:3046-3049. [PMID: 31850120 PMCID: PMC6910795 DOI: 10.3889/oamjms.2019.766] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 07/04/2019] [Accepted: 07/05/2019] [Indexed: 11/28/2022] Open
Abstract
Dermatoporosis is an important clinical condition leading to chronic skin fragility. It can be separated into primary and secondary subtypes, with the latter induced by medical drugs and environmental factors. Dermatoporosis can be classified into 4 major stages with increasing morbidity and mortality with the advanced stages. Its aetiology has been related to the epidermal hyalusome. Dermatoporosis is a cause of mortality in the intensive care unit and should be known not only by a dermatologist but another medical speciality as well. Prevention is of major importance. Therapeutic options are limited but available.
Collapse
Affiliation(s)
- Uwe Wollina
- Department of Dermatology and Allergology, Städtisches Klinikum Dresden, Academic Teaching Hospital, Dresden, Germany
| | - Torello Lotti
- Department of Dermatology, University of Rome "G. Marconi", Rome, Italy
| | | | - Andreas Nowak
- Department of Anesthesiology and Intensive Care Medicine, Emergency Medicine and Pain Management, Städtisches Klinikum Dresden, Dresden, Germany
| |
Collapse
|
11
|
Kaya G, Kaya A, Sorg O, Saurat JH. Dermatoporosis: a further step to recognition. J Eur Acad Dermatol Venereol 2019; 32:189-191. [PMID: 29465833 DOI: 10.1111/jdv.14777] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- G Kaya
- Department of Dermatology, University of Geneva, Geneva, Switzerland
| | - A Kaya
- Department of Clinical Pharmacology and Toxicology, University of Geneva, Geneva, Switzerland
| | - O Sorg
- Department of Clinical Pharmacology and Toxicology, University of Geneva, Geneva, Switzerland
| | - J-H Saurat
- Department of Clinical Pharmacology and Toxicology, University of Geneva, Geneva, Switzerland
| |
Collapse
|
12
|
Vanzi V, Toma E. Recognising and managing age-related dermatoporosis and skin tears. Nurs Older People 2019; 30:26-31. [PMID: 29569862 DOI: 10.7748/nop.2018.e1022] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2018] [Indexed: 11/09/2022]
Abstract
Dermatoporosis is a chronic skin fragility syndrome, caused by age and environmental factors. People with dermatoporosis have skin whose protective mechanical function is reduced and which has a decreased tolerance for friction and shearing forces. Skin tears are another clinical consequence of age-associated skin vulnerability and people with dermatoporosis are at increased risk of skin tears. Dermatoporosis may also delay the healing of skin tears, making it vital that healthcare professionals are aware of this condition. Skin tears have profound effects on the health and well-being of older people, and these kinds of injuries are being seen more frequently in clinical practice as the average age of the population increases. The treatment of skin tears in three older people with dermatoporosis is discussed and the clinical decisions made in each case.
Collapse
Affiliation(s)
| | - Elena Toma
- Wound care, independent tissue viability consultant, Rome, Italy
| |
Collapse
|
13
|
Kluger N, Impivaara S. Prevalence of and risk factors for dermatoporosis: a prospective observational study of dermatology outpatients in a Finnish tertiary care hospital. J Eur Acad Dermatol Venereol 2018; 33:447-450. [DOI: 10.1111/jdv.15240] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Accepted: 08/29/2018] [Indexed: 11/29/2022]
Affiliation(s)
- N. Kluger
- Department of Dermatology, Allergology and Venereology; Helsinki University Central Hospital and University of Helsinki; Helsinki Finland
| | - S. Impivaara
- Department of Dermatology, Allergology and Venereology; Helsinki University Central Hospital and University of Helsinki; Helsinki Finland
| |
Collapse
|
14
|
Ordioni U, Hadj Saïd M, Thiery G, Campana F, Catherine JH, Lan R. Angina bullosa haemorrhagica: a systematic review and proposal for diagnostic criteria. Int J Oral Maxillofac Surg 2018; 48:28-39. [PMID: 30032974 DOI: 10.1016/j.ijom.2018.06.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Revised: 06/19/2018] [Accepted: 06/29/2018] [Indexed: 01/17/2023]
Abstract
The aim of this study was to perform a critical review of published data on the epidemiological, aetiological, clinical, histological, biological, and therapeutic characteristics of patients with angina bullosa haemorrhagica (ABH). A literature search was conducted in the PubMed, Science Direct, Web of Science, and Cochrane Library databases. All publications fulfilling the selection criteria were included in the eligibility assessment according to the PRISMA statement. The full texts of 54 retrieved articles were screened. Forty articles published between 1985 and 2016 describing 225 cases of ABH were finally selected. The mean age of the patients was 55.4 years; the male to female ratio was 0.7. The predominant localization was the palate (66%). A third of patients had no medical history. When specified, a triggering event or promoting factor was frequently found (82%). Biological tests were normal. A biopsy was performed on 35% of the patients. Treatment was symptomatic with a favourable outcome. Recurrences were frequent (62%). In conclusion, ABH is poorly documented and only by studies of low-level evidence. This review did not allow any aetiopathogenic association to be made with a general pathology or treatment. On the basis of this systematic review of the literature, diagnostic criteria aiming to improve the care of patients presenting with ABH are proposed.
Collapse
Affiliation(s)
- U Ordioni
- Department of Oral Surgery and Odontology, APHM, Timone Hospital, Marseille, France; Centre Massilien de la Face, Marseille, France.
| | - M Hadj Saïd
- Department of Oral Surgery and Odontology, APHM, Timone Hospital, Marseille, France; Faculty of Medicine, Aix-Marseille University, EFS/CNRS, APHM, Marseille, France
| | - G Thiery
- Centre Massilien de la Face, Marseille, France
| | - F Campana
- Department of Oral Surgery and Odontology, APHM, Timone Hospital, Marseille, France; Centre Massilien de la Face, Marseille, France
| | - J-H Catherine
- Department of Oral Surgery and Odontology, APHM, Timone Hospital, Marseille, France; Faculty of Medicine, UMR 7268 ADES, Aix-Marseille University/EFS/CNRS, Marseille, France
| | - R Lan
- Department of Oral Surgery and Odontology, APHM, Timone Hospital, Marseille, France; Faculty of Medicine, UMR 7268 ADES, Aix-Marseille University/EFS/CNRS, Marseille, France
| |
Collapse
|
15
|
Koyano Y, Nakagami G, Minematsu T, Sanada H. Reliability of the skin blotting method when used on the elderly. Int Wound J 2018; 15:807-813. [PMID: 29897658 DOI: 10.1111/iwj.12931] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Accepted: 03/19/2018] [Indexed: 12/01/2022] Open
Abstract
The aim of this study was to compare protein secretion on intact skin of extremities and verify the relationship between the marker proteins on abdominal skin and systemic factors using skin blotting. A cross-sectional study was conducted among elderly patients aged 65 years and older (N = 73) at a long-term medical facility in Japan. Skin blotting was performed on the right and left forearms, right and left lower legs, and abdomen. Pearson's correlations and Bland-Altman plots were utilised for comparing the protein secretion from the skin between the right or left forearms or lower legs. Multiple regression analysis was applied to determine the relationship between intensity levels of 3 proteins on the abdominal skin and the systemic factors. Bland-Altman plots demonstrated that there was no significant difference between right and left secretion levels on the forearms and lower legs among 3 proteins. Multiple regression analysis showed that age and antiplatelet use was positively associated with decreased collagen type IV and increased matrix metalloproteinase 2 levels, respectively. Our findings suggested that collecting samples from either the right or the left skin would be sufficient if skin properties between arms and legs are evaluated using skin blotting.
Collapse
Affiliation(s)
- Yuiko Koyano
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Gojiro Nakagami
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takeo Minematsu
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiromi Sanada
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| |
Collapse
|
16
|
|
17
|
Beele H, Smet S, Van Damme N, Beeckman D. Incontinence-Associated Dermatitis: Pathogenesis, Contributing Factors, Prevention and Management Options. Drugs Aging 2017; 35:1-10. [DOI: 10.1007/s40266-017-0507-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
|
18
|
Truchetet F. La dermatose érosive et pustuleuse. Ann Dermatol Venereol 2017; 144:579-581. [DOI: 10.1016/j.annder.2017.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
19
|
Saurat JH, Mengeaud V, Georgescu V, Coutanceau C, Ezzedine K, Taïeb C. A simple self-diagnosis tool to assess the prevalence of dermatoporosis in France. J Eur Acad Dermatol Venereol 2017; 31:1380-1386. [DOI: 10.1111/jdv.14240] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Accepted: 02/27/2017] [Indexed: 11/26/2022]
Affiliation(s)
| | - V. Mengeaud
- Département Exploration Cutanée; Centre de Recherche sur la Peau; Pierre Fabre Dermo-Cosmetique; Toulouse France
| | - V. Georgescu
- Medical Department; Laboratoires Dermatologiques Avène; Lavaur France
| | - C. Coutanceau
- Medical Department; Laboratoires Dermatologiques Avène; Lavaur France
| | - K. Ezzedine
- Department of Dermatology; Hôpital Henri Mondor EA EpiDermE (Epidémiologie en Dermatologie et Evaluation des Thérapeutiques) EA 7379; UPEC-Université Paris-Est Créteil; Créteil France
| | - C. Taïeb
- Public Health; European Market Maintenance Assessment-EMMA; Vincennes France
- Public Health; Hôpital Necker-Enfants Malades; Maladies Rares en Dermatologie; Paris France
| |
Collapse
|
20
|
Iizaka S, Nagata S, Sanada H. Nutritional Status and Habitual Dietary Intake Are Associated with Frail Skin Conditions in Community-Dwelling Older People. J Nutr Health Aging 2017; 21:137-146. [PMID: 28112767 DOI: 10.1007/s12603-016-0736-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Prevention of frail skin is important in older people because frail skin is associated with a risk of injury in this population. In this study, we investigated the association of nutritional status and habitual dietary intake with skin conditions in community-dwelling older people. DESIGN Cross-sectional study. SETTING Three community settings in Japan from autumn to winter. PARTICIPANTS Older people aged ≥65 years without care-need certification (n=118). MEASUREMENTS Malnutrition and obesity were evaluated to assess the nutritional status. Nutrient and food group intakes per 1000 kcal were evaluated using a brief self-administered diet history questionnaire. Dietary patterns based on food groups were evaluated by principal component analysis. Skin condition parameters, including stratum corneum hydration, appearance of xerosis (specific symptom sum score [SRRC score]), and dermal intensity by high-frequency ultrasonography, were measured on a lower leg. Multiple linear regression analysis was performed with adjustment for confounders. RESULTS The mean (standard deviation) age was 74.1 (4.8) years, and 83.1% of participants were female. A higher intake of plant fat (p=0.018) was associated with a lower SRRC score. Higher intakes of α-tocopherol (p=0.050) and vitamin C (p=0.017) were associated with increased dermal intensity. A body mass index ≥25 (p=0.016) was associated with decreased dermal intensity. A dietary pattern characterized by higher vegetable and fruit intake was associated with a better skin condition. CONCLUSION Plant fat, antioxidant vitamins, and a dietary pattern characterized by vegetables and fruits showed positive and obesity showed negative associations for frail skin in community-dwelling older people.
Collapse
Affiliation(s)
- S Iizaka
- Shinji Iizaka, RN, PhD, School of Nutrition, College of Nursing and Nutrition, Shukutoku University. 673 Nitonacho, Chuo-ku, Chiba-shi, Chiba, Japan Phone:81-43-305-1881 E-mail:
| | | | | |
Collapse
|
21
|
Bizarre looking forearm blotches: Dermatoporosis exacerbated by repetitive use of a cupping glass. DERMATOL SIN 2016. [DOI: 10.1016/j.dsi.2015.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
|
22
|
Lichterfeld A, Lahmann N, Blume-Peytavi U, Kottner J. Dry skin in nursing care receivers: A multi-centre cross-sectional prevalence study in hospitals and nursing homes. Int J Nurs Stud 2016; 56:37-44. [DOI: 10.1016/j.ijnurstu.2016.01.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 01/06/2016] [Accepted: 01/06/2016] [Indexed: 01/24/2023]
|
23
|
Humbert P, Dréno B, Krutmann J, Luger TA, Triller R, Meaume S, Seité S. Recommendations for managing cutaneous disorders associated with advancing age. Clin Interv Aging 2016; 11:141-8. [PMID: 26929610 PMCID: PMC4758790 DOI: 10.2147/cia.s96232] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The increasingly aged population worldwide means more people are living with chronic diseases, reduced autonomy, and taking various medications. Health professionals should take these into consideration when managing dermatological problems in elderly patients. Accordingly, current research is investigating the dermatological problems associated with the loss of cutaneous function with age. As cell renewal slows, the physical and chemical barrier function declines, cutaneous permeability increases, and the skin becomes increasingly vulnerable to external factors. In geriatric dermatology, the consequences of cutaneous aging lead to xerosis, skin folding, moisture-associated skin damage, and impaired wound healing. These problems pose significant challenges for both the elderly and their carers. Most often, nurses manage skin care in the elderly. However, until recently, little attention has been paid to developing appropriate, evidence-based, skincare protocols. The objective of this paper is to highlight common clinical problems with aging skin and provide some appropriate advice on cosmetic protocols for managing them. A review of the literature from 2004 to 2014 using PubMed was performed by a working group of six European dermatologists with clinical and research experience in dermatology. Basic topical therapy can restore and protect skin barrier function, which relieves problems associated with xerosis, prevents aggravating moisture-associated skin damage, and enhances quality of life. In conclusion, the authors provide physicians with practical recommendations to assist them in implementing basic skin care for the elderly in an integrated care approach.
Collapse
Affiliation(s)
- Philippe Humbert
- Research and Studies Centre on the Integument (CERT), Clinical Investigation Centre (CIC BT506), Department of Dermatology, Besançon University Hospital, University of Franche-Comté, Besançon, France
| | - Brigitte Dréno
- Department of Dermato-Cancerology, Nantes University Hospital, Nantes, France
| | - Jean Krutmann
- IUF-Leibniz Research Institute for Environmental Medicine, Heinrich-Heine-University, Düsseldorf, Germany
| | | | - Raoul Triller
- International Centre of Dermatology, Hertford British Hospital, Levallois, France
| | - Sylvie Meaume
- Geriatric Service, Wounds and Healing, Rothschild Hôspital, Paris, France
| | - Sophie Seité
- La Roche-Posay Dermatological Laboratories, Asnières, France
| |
Collapse
|
24
|
Rayner R, Carville K, Leslie G, Roberts P. A review of patient and skin characteristics associated with skin tears. J Wound Care 2015; 24:406-14. [DOI: 10.12968/jowc.2015.24.9.406] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- R. Rayner
- School of Nursing and Midwifery, Curtin University and Silver Chain Group, Western Australia
| | - K. Carville
- School of Nursing and Midwifery, Curtin University and Silver Chain Group, Western Australia
| | - G. Leslie
- School of Nursing and Midwifery, Curtin University, Western Australia
| | - P. Roberts
- School of Nursing and Midwifery, Curtin University, Western Australia
| |
Collapse
|
25
|
|
26
|
Skin rejuvenation with non-invasive pulsed electric fields. Sci Rep 2015; 5:10187. [PMID: 25965851 PMCID: PMC4428072 DOI: 10.1038/srep10187] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 03/19/2015] [Indexed: 01/09/2023] Open
Abstract
Degenerative skin diseases affect one third of individuals over the age of sixty. Current therapies use various physical and chemical methods to rejuvenate skin; but since the therapies affect many tissue components including cells and extracellular matrix, they may also induce significant side effects, such as scarring. Here we report on a new, non-invasive, non-thermal technique to rejuvenate skin with pulsed electric fields. The fields destroy cells while simultaneously completely preserving the extracellular matrix architecture and releasing multiple growth factors locally that induce new cells and tissue growth. We have identified the specific pulsed electric field parameters in rats that lead to prominent proliferation of the epidermis, formation of microvasculature, and secretion of new collagen at treated areas without scarring. Our results suggest that pulsed electric fields can improve skin function and thus can potentially serve as a novel non-invasive skin therapy for multiple degenerative skin diseases.
Collapse
|
27
|
Barnes L, Kaya G, Rollason V. Topical Corticosteroid-Induced Skin Atrophy: A Comprehensive Review. Drug Saf 2015; 38:493-509. [DOI: 10.1007/s40264-015-0287-7] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
|
28
|
Powell JB, Gach JE. Phototherapy in the elderly. Clin Exp Dermatol 2015; 40:605-10. [PMID: 25809797 DOI: 10.1111/ced.12626] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/16/2014] [Indexed: 11/29/2022]
Affiliation(s)
- J. B. Powell
- Department of Dermatology; Worcestershire Royal Hospital; Worcester UK
| | - J. E. Gach
- Department of Dermatology; University Hospitals Coventry and Warwickshire; Coventry West Midlands UK
| |
Collapse
|
29
|
Nikolic DS, Ziori C, Kostaki M, Fontao L, Saurat JH, Kaya G. Hyalurosome Gene Regulation and Dose-Dependent Restoration of Skin Atrophy by Retinaldehyde and Defined-Size Hyaluronate Fragments in Dermatoporosis. Dermatology 2014; 229:110-5. [DOI: 10.1159/000362594] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Accepted: 03/09/2014] [Indexed: 11/19/2022] Open
|
30
|
Reversal of Murine Epidermal Atrophy by Topical Modulation of Calcium Signaling. J Invest Dermatol 2014; 134:1599-1608. [DOI: 10.1038/jid.2013.524] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2013] [Revised: 11/19/2013] [Accepted: 11/20/2013] [Indexed: 11/08/2022]
|
31
|
Kurashige Y, Minemuta T, Nagatani T. Three cases of sacral pressure ulcers presenting primary dermatoporosis on the forearms. Case Rep Dermatol 2013; 5:73-8. [PMID: 23626543 PMCID: PMC3617970 DOI: 10.1159/000350286] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The relatively new term dermatoporosis refers to chronic deficiencies in the skin's functions in the elderly population due to aging. This syndrome is marked by chronic cutaneous fragility clinically represented by skin atrophy, senile purpura, stellate pseudoscars, skin laceration, and dissecting hematoma of the skin. In this paper, we report three cases of sacral pressure ulcers presenting primary dermatoporosis on the forearms. Case 1 was a 74-year-old male who presented with a stage IV sacral pressure ulcer. The signs of dermatoporosis appeared on the forearms. Histopathology of the lesions revealed epidermal thinning with loss of rete ridges. Azan and Elastica van Gieson staining demonstrated the degeneration of the dermal collagen fibers and elastic fibers, respectively. In spite of 6 months of treatment, the ulcer failed to heal sufficiently. Case 2 was a 74-year-old male and Case 3 was a 97-year-old female. Both cases presented with a stage II sacral pressure ulcer and dermatoporosis on the forearms. Histopathological examinations and the clinical course of the wound could not be ascertained in Cases 2 and 3. None of the patients had previously used corticosteroids. The presence of a primary dermatoporosis on the forearms in these cases may be associated with the increased risk of pressure ulcer development.
Collapse
Affiliation(s)
- Yuta Kurashige
- Department of Dermatology, Hachioji Medical Center, Tokyo Medical University, Tokyo, Japan
| | | | | |
Collapse
|
32
|
Abstract
Dermatoporosis is a novel term proposed to describe the chronic cutaneous insufficiency/fragility syndrome characterized by an extreme skin atrophy. Dermatoporosis is principally due to chronological aging and long-term and unprotected sun exposure, but it may also result from the chronic use of topical and systemic corticosteroids. We have recently proposed a membrane organelle, hyalurosome, composed of molecules involved in hyaluronate (HA) metabolism and cell signaling in the keratinocytes, such as principal HA receptor CD44, heparin-binding epidermal growth factor (HB-EGF), HB-EGF receptor erbB1 and HA synthase 3 (HAS3), which is functionally defective in dermatoporosis and may be a target for intervention. Several lines of evidence suggest that hyalurosome is located in keratinocyte filopodia, thin, actin-rich plasma membrane protrusions implicated in cell motility. We have recently shown that keratinocyte filopodia are downregulated by corticosteroids in vitro. Intermediate size HA fragments (HAFi) inhibited the downregulation of filopodia induced by corticosteroids. Topical HAFi prevented the skin atrophy induced by topical corticosteroids in mice without interfering with their anti-inflammatory effect. Topical treatment with HAFi 1% of atrophic forearm skin of dermatoporosis patients for 1 month resulted in a significant clinical improvement and induced the expression of hyalurosome molecules. Topical retinaldehyde (RAL) and HAFi showed a synergy in HA production and pro-HB-EGF expression in mouse skin and in the correction of skin atrophy in dermatoporosis patients. Uncovering the molecular mechanisms implicating hyalurosome seems to be crucial to better understand the pathogenesis of dermatoporosis and to develop new therapeutic strategies.
Collapse
Affiliation(s)
- G Kaya
- Department of Dermatology, University Hospital of Geneva, Geneva, Switzerland
| |
Collapse
|